The Need for ehealth Strategies

Transcription

1 The Need for ehealth Strategies Lincoln A Moura Jr, EE, MSc, DIC, PhD President, IMIA International Medical Informatics Association lamoura@uol.com.br

2 About IMIA IMIA was founded in 1967 as an SIG within IFIP An international, not-for-profit Association of Associations' A 'bridging organization' to bring together the members of the global health and biomedical informatics communities 65 Member Societies contacts in over 85 countries 25 WG and SIG 6 IMIA Regions: APAMI, NA, IMIA-LAC, MEAHI, HELINA and EFMI Academic and Corporate Members Represents over 50,000 people in Health and Biomedical Informatics IMIA has formal relations with: World Health Organization (WHO) ISO TC 215 (Liaison A) International Federation for Information Processing (IFIP) International Federation of Health Records Organizations (IFHRO) 2

3 IMIA Activities Medinfo Is IMIA s major meeting 13 Medinfosso far To be held every two years from 2013 on Nursing Informatics Is Nursing Informatics SIG major meeting To be held every other year from 2012 on Yearbook (since 1992) Comprehensive selection of Health and Biomedical Informatics papers published every year. Excellent source of first class references. Open-access now 3

4 Official IMIA Publications Methods of Information in Medicine (Schattauer Publishers Stuttgart) Applied Clinical Informatics (Schattauer Publishers Stuttgart) International Journal of Medical Informatics (Elsevier) - Sponsored 4

5 Other Activities Regional Meetings Support to Regions whose organization is under development as MEAHI, HELINA and IMIA-LAC Collaboration with Sister Organizations Events and publications with WHO WHO Bulletin nº90, May 2012 ehealth WHA Resolution 66.24, May ehealth TC 215 ISO/JIC Other IMIA Publications Code of Ethics, 2001 under review IMIA Education Recommendations, 2010 STARE-HI StatementonReportingofEvaluationStudiesin Health Informatics, 2008 Task Forces for specific issues: Strategic Plan 5

6 Important Global Activities IMIA WHO Collaboration WHO has provided the vehicle, guidance and methods IMIA has provided coordination and knowledge Help with Resolution WHA May 2013 The project has counted on funding from PEPFAR and IDRC 6

7 WGsandSIG Biomedical Pattern Recognition Consumer Health Informatics Critical Care Informatics Dental Informatics Health and Medical Informatics Education Health Informatics for Development Health Information Systems Human Factors Engineering for Healthcare Informatics Informatics in Genomic Medicine (IGM) Intelligent Data Analysis and Data Mining Medical Concept Representation Mental Health Informatics Open Source Health Informatics Organizational and Social Issues Primary Health Care Informatics Security in Health Information Systems SIG NI Nursing Informatics Smart Homes and Ambient Assisted Living Social Media Standards in Health Care Informatics Technology Assessment & Quality Development in Health Informatics Telehealth (provisional) Wearable Sensors in Healthcare 7

8 To Summarize IMIA s State of Mind is: We need to Collaborate; IMIA is in an excellent position as a unbiased and global organization; IMIA s reach should not be underestimate, although we need to improve our organizational resources as we are indeed doing; The WHO Bulletin on ehealthand the WHA Resolution are important examples of how productive collaboration can be; We are keen to listen to ideas on how to collaborate with other organizations in a win-win and sustainable relationship; Strategic Plan: Towards IMIA 2022 Open for comments 8

9 ehealth Strategies 9

10 Waves First Wave Investment in ehealth in countries as UK, USA, Canada, Australia, Sweden, Denmark and New Zealand; Successes, Disappointments and Failures Second Wave Increased and widespread perception that ehealth is VERY IMPORTANT to all countries no matter their maturity level; ISO WHO-ITU WHA Several countries started working on National ehealth Strategies Future Consolidate the value of ehealth Strategies, including policies but not limited to them. 10

11 ROI em esaúde: ehealth is Worth it: The economic benefits of implemented ehealth solutions at ten European sites Source: ehealth Impact,

12 ROI in ehealth in the European Communitiy Source: ehealth Impact,

13 Complexity and Reach

14 WHA Resolution ehealth standardization and interoperability URGES Member States: (1) to consider, as appropriate, options to collaborate with relevant stakeholders, including national authorities, relevant ministries, health care providers, and academic institutions, in order to draw up a road map for implementation of ehealthand health data standards at national and subnational levels; (2) to consider developing, as appropriate, policies and legislative mechanisms linked to an overall national ehealthstrategy, in order to ensure compliance in the adoption of ehealthand health data standards by the public and private sectors, as appropriate, and the donor community, as well as to ensure the privacy of personal clinical data; (3) to consider ways for ministries of health and public health authorities to work with their national representatives on the ICANN Governmental Advisory Committee in order to coordinate national positions towards the delegation, governance and operation of health-related global top-level domain names in all languages, including.health, in the interest of public health; 14

15 ISO TR ehealth Architecture Roadmap 15

16 Process is essentially Incremental and Iteractive 16

17 ehealth Strategy Objectives Define a Strategic Vision Identify Strategic Recommendations Likely to find the need for some Immediate Action (extension to the Toolkit) Strategic Vision Projects, Systems & Initiatives Guidance and Alignment t 17

18 The Inspiration Part 1 National ehealth Vision Part 2 National ehealth Action Plan Part 3 National ehealth Monitoring & Evaluatiion 18

19 The ITU-WHO Method for a National ehealth Strategy 19

20 The Building Blocks of the Strategy 20

21 Grouping the Building Blocks Leadership and Governance Strategy and Investment Services and Applications Legislation, Policy and Compliance Work Force Standards & Interoperability Infrastructure Organizational Resources Infrastructure Infostructure Human Resources 21

22 Main Task Identify and assess the main existing ehealth projects or initiatives that are likely to impact the ehealth Vision Identify aspects of Organizational Resources Infostructure Infrastructure, and Human Resources that are required to deliver the proposed ehealth Vision 22

23 The Essence of the Method Existing Initiatives Identify the Required Building Blocks Identify Existing Building Blocks Propose Acionsto deal with the identified Gaps Which building blocks do exist? Which can be reused? What is needed to allow for reuse? 23

24 ehealth and its Pillars Infrastructure equipment, datacenters, mobile devices, telecommunications Human Resources IT staff, managers and end-users IT Architecture methods, models, processes and standards Organizational Resources National (or Regional) Policies and Regulations Legal and enabling instruments Enterprise Architecture / Strategic Planning Governance models Sponsorship and ownership Motivation, readiness and emotional room for change Practices and culture of using IT Leadership and advocacy Knowledge and project management skills Project stability no disruption. 24

25 Example: Legislation, policy and compliance What data protection legislation and regulatory frameworks exist? Which areas do existing data protection legislation and regulatory frameworks address, suchas individuals choice to opt in or opt out of the collection of their personal health information; Do existing legislation and regulatory frameworks support or constrain the sharing of health information across geographical and health sector boundaries? Who is responsible for regulating compliance with data protection legislation, in particular across the nation s health sector? What risks do existing data protection legislation and regulatory frameworks pose to the growth and development of the national ehealth environment? 25

26 In Brazil: People from a Variety of Profiles and Organizations Overall management by MoH, via DATASUS; 1 Coordinating Group 60 people; 6 presencial Workshops; 4 Working Groups; 25 virtual WG meetings; 4 face-to-face WG meetings; 1 website for documentstorageand distribution; Mostly based on volunteer work; Only4 consultantspaidtoworkin theproject; Currentstatus: tobesenttopublicconsultationbytheendofjuly

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28 The Proposed Strategic Actions 1 ReduceeHealthfragmentationwithintheNationalHealth System 2 Strengthen overall Governance of ehealth within the Federal Govmt 3 Define thorough legislation to support ehealth 4 Establish a robust ehealth Architecture 5 Define and deploy interoperable ehealth services 6 Promote infrastructure as a service(iaas) 7 Propose and deploy a reference Architecture for IaaS 8 Develop ehealth capacity building/ certificates for Health Workers 9 Promote access to Health Information by the population 28

29 The Need for an Architecture Recognize and provide answers to wide organizational needs Corporate, federal or state governments, large communities... Driven by Strategic Goals Integration Policies, Regulations, Norms, IT Architectures, Infrastructure, HR Independence & Liberty Organizational Resources Infrastructure IT Architecture Human Resources Recognize and provide answers to local and specific needs Specialties, cities, small communities... Driven by local needs 29

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32 Conclusion ehealth can change Health Technology is a problem, but NOT the problem No single system can sort out all the problems Need for Standards for Interoperability Say No to Siloed-Systems National Unique IDs are Essential Need for ICT Infrastructure HR Capacity Building Good Methods are Required Think Big, Analyze the Roadmap, Walk through Step by Step Give ourselves time to learn Strategies and Architectures are worth the trouble Keep the 7 pillars in mind, at all times and at all cost 32

33 The Role for IMIA Tobemore activein thisfield CollaboratewithWHO, ITU, ISO, JIC Promote ehealth Capacity Building Strengthen its Standards Working Group Act as a Bridge between SDOs, IMIA Regions and Member Socities 33

34 - Lincoln A Moura Jr, EE, MSc, DIC, PhD President IMIA International Medical Informatics Association lamoura@uol.com.br